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. 2025 May 20;16(1):825.
doi: 10.1007/s12672-025-02668-z.

Survival outcomes and prognostic factors of breast cancer spinal metastases: a retrospective study

Panpan Hu #  1 , Xin Wu #  1   2 , Yan Li #  1 , Feng Wei  3 , Shengxin Zeng  1 , Yu Xiao  4 , Xiaoguang Liu  1 , Zhongjun Liu  1
Affiliations

Survival outcomes and prognostic factors of breast cancer spinal metastases: a retrospective study

Panpan Hu et al. Discov Oncol. .

Abstract

Purpose: To investigate survival-related factors in patients with breast cancer spinal metastases (BCSM) within the context of multidisciplinary treatment.

Methods: A retrospective cohort of 78 cases from July 2010 to December 2021 was recruited. These patients underwent surgery-based multidisciplinary treatment. Collected data included demographics, pathologies, symptoms, surgery-related data, adjuvant therapies, postoperative events, and survival data. The primary outcome was overall survival (OS). Kaplan-Meier survival curves were plotted. Univariate analysis employed the log-rank test, and post-hoc multivariate analysis utilized the Cox regression model.

Results: The mean age was 50.9 years. 72 cases (92.3%) reported locoregional pain, and 30 cases (38.5%) presented with neurological dysfunction. The primary pathological subtype was invasive ductal carcinoma (83.3%).

Surgical procedures: total en-bloc spondylectomy (6.4%), debulking surgery (61.5%), palliative surgery (32.1%). Postoperatively, both pain and neurological function significantly improved (P < 0.05). Radiotherapy, endocrine therapy, chemotherapy/targeted therapy were given to 56.4%, 60.3%, 61.5% patients, respectively. The estimated OS was 50.0 months. Tomita's scores (P = 0.355) and Tokuhashi's scores (P = 0.461) showed no significant OS association. Univariate analysis indicated that preoperative neurological dysfunction (P = 0.003), postoperative neurological dysfunction (P = 0.051), adjuvant endocrine therapy (P = 0.025), and hormone receptor expression status (P = 0.009) were associated with patient survival. Multivariate analysis identified endocrine therapy as an independent protective factor for prognosis (aHR = 0.070, 95% CI 0.007-0.727, P = 0.026).

Conclusions: Patients with BCSM have experienced prolonged survival. Neurological status, adjuvant anti-drugs, and expression of hormone receptors played crucial roles in predicting survival. Conventional prognostic systems may require modification to incorporate these factors. However, this study has limitations inherent to its retrospective design, single-center cohort, and relatively small sample size, which may affect generalizability.

Keywords: Breast cancer; Prognostic analysis; Spinal metastasis; Surgery; Survival.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was approved by the institutional ethics committee of Peking University Third Hospital (approval number: M2023797), and performed in accordance with the ethical standards of the Declaration of Helsinki (1964) and its subsequent amendments. Informed consent was obtained from all individual participants included in the study. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan–Meier survival curve of the cohort
Fig. 2
Fig. 2
a, Kaplan–Meier survival curves of the subgroups of the three surgical methods; b, survival curves of TES subgroup versus non-TES subgroup; c, survival curves of palliative subgroup versus tumor-excision subgroup
Fig. 3
Fig. 3
a Kaplan–Meier survival curves of the three subgroups of Tomita’s scores; b survival curves of the three subgroups of Tokuhashi’s scores
See this image and copyright information in PMC

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References

    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70:7–30. 10.3322/caac.21590. - PubMed
    1. Wright E, Ricciardi F, Arts M, et al. Metastatic spine tumor epidemiology: comparison of trends in surgery across two decades and three continents. World Neurosurg. 2018;114:e809–17. 10.1016/j.wneu.2018.03.091. - PubMed
    1. Coleman RE. Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res. 2006;12:6243s–9s. 10.1158/1078-0432.Ccr-06-0931. - PubMed
    1. Tahara RK, Brewer TM, Theriault RL, et al. Bone metastasis of breast cancer. Adv Exp Med Biol. 2019;1152:105–29. 10.1007/978-3-030-20301-6_4. - PubMed
    1. Landreneau FE, Landreneau RJ, Keenan RJ, et al. Diagnosis and management of spinal metastases from breast cancer. J Neurooncol. 1995;23:121–34. 10.1007/bf01053417. - PubMed

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